Let's Talk About Sex. A Brief Overview on MS and Sexuality (Part 1) | SMart Choice Lifestyle

WARNING! Neuro and anatomy geek down below! This is where I get nerdy about how the brain and body work together. Continue at your own risk! :))

We all do it. We all enjoy it (hopefully!). We talk about these issues with our partners and friends. But there comes Multiple Sclerosis and it all goes silent. I personally find this silence very intriguing. Is it the shame of having MS itself or the shame of not being able to enjoy it / do it as much because of MS? I am aware that some people might naturally not feel comfortable talking about this, but that's not the topic we're after today.

Either way, I think sexuality when dealing with MS is an issue that needs some light shed upon it. And this is what I'm going to do in this article today. Just to make things clear from the very beginning: not everyone with MS will experience sex problems!

I think it's useful to learn as much as you can about how MS symptoms affect your day to day life, just so that by "knowing your enemy" and your body, you'll have better coping techniques if anything goes wrong. Hoping for the better and without further adue, let's start!

Don't get your expectations too high, boys and girls! You're not gonna read about steamy techniques or how to perform better. It's ANATOMY time!

If you're still reading, it means I got my point across already. So, let's get into some details and more specific things. When I first heard that sexual disfunction could be one of the symptoms of MS, I began asking myself questions. Why does it happen and most of all... how? Enter research-mode! Here is what I found out...


We know that in MS, the disease affects different nerves in the body. Some of them control our sexual function (arousal, climaxing, etc). When inflammation and damage happens to those particular brain pathways, some signals might get disturbed and interfere with the function itself. Not to mention that there can be other symptoms that can prove to be disturbing and not allowing you to even think about sex in the first place, let alone worry about not feeling aroused properly!

Our brains are the the biggest sex organs in our bodies. They are responsible for all things ranging from our emotions, perceptions of pain and pleasure, memories. In charge with the way our hearts, nerves and sensations perform. Most of all, the brain (the hypothalamus region) is involved in secreting the hormones that influence sexual feelings and responses (oxytocin, vasopressin, serotonin, dopamine). 

The brain receives and processes messages from our sensory organs, giving you information about how other things and people (including yourself) look, sound, taste, smell, feel to you. It also sends and receives signals regarding your blood pressure, heart rate, breath and body temperature. These are all big parts of sexual function, experience and response.

Sex is a type of communication between two humans, at a very intimate level. It's also a communication between the brain and the rest of your body. Sexuality happens mostly inside our brains, as all its parts are regulated there: physical, sensory, chemical, emotional, psychological, intellectual, social, cultural issues are all born between the synapses of the brain.

It's important to know how the brain does all its "magic" that makes us who we are. For today, I'll talk about the parts of the brains' inner system. Your nervous system is made out of a few parts:

1.  Central Nervous System (CNS) (the brain, spinal cord and optic nerves)
2. Peripheral Nervous System (the nerves that mediate the communication with the world)
a) Somatic Nervous System (the nerves that carry the sensory information to the brain)
b) Autonomic (or Vegetative) Nervous System (which regulates the action/rest responses of all body parts) which is also made out of two smaller parts:
    - Sympathetic Nervous System - handling the action, excitement and keeping you alert;
   - Parasympathetic Nervous System- handling the rest, calming and relaxation functions of the body.

For the sexual act to happen normally, the parasympathetic (relaxation part) needs to dominate the sympathetic (arousal part). If the first loses control, you're faced with premature ejaculation. So, here are a few substances you need to stay away from if you're faced with similar issues: alcohol, smoking, coffee, tea, cola drinks. They all accelerate the sympathetic system (they increase your sense of feeling "nervous", "agitated")

Although our bodies are made with the same pattern, our sensitivity is different. Some areas of the body have more sensory nerve receptors that send the messages to and from the brain. Individual sensitivity is different. 

Past experiences as well as spinal cord integrity are important for how sensitive we are / become to both pain and pleasure. We all have erogenous zones, areas of the body with high sensitivity which we find more sexually stimulating than others. 

Sexual arousal / response and orgasm depend on healthy spinal cord connections and undamaged nerve pathways between the brain and the base of the spine. To understand it properly, we need to divide it into sections:

1. CERVICAL - the area starting from below the skull up until above the ribs;
2. THORACIC - the area of your chest (ribs) up until above the belly;
3. LUMBAR - the area starting below the ribs and up above your lower back;
4. SACRAL - the area below your lower back up until the tailbone;

Out of all the nerves in our bodies, about 20% or them are sexual. We are interested only in the last three areas, as they are the ones responsible for conducting and controlling the sexual function throughout the body. Here we go!

THORACIC - have 3 pairs of sympathetic nerves that innervate the breasts (nipples): 3 nerves on the right and 3 on the left side of the body (the 4th, 5th and 6th thoracic nerves) - they cause the nipples to become erect. Being of the sympathetic type, they transmit signals to the brain whenever the breasts are touched and caressed. At the same time, the body sends signals through the spinal cord to the brain, causing the erection.

LUMBAR - 3 pairs of sympathetic nerves (the 1st, 2nd and 3rd lumbar nerves) - they innervate the penis and the vagina and are activated two times during the sexual act: at the beginning and during the last part, during orgasm/ejaculation.

SACRAL - 3 pairs of parasympathetic nerves (2nd, 3rd and 4th sacral nerves) - they are responsible for prolonging the erection during foreplay and intercourse.

(Side note: I've used the term erection twice now, and I'm refering to both male and female arousal. We'll get more detailed in the second part, where I add more about each genders' sexual system.)


The Pudendal Nerve is located right in the sacral region of the body, at the bottom of the spinal cord and is the main nerve of the perineum. It is the one that innervates the anus, perineum, penis, clitoris and areas around the scrotum.



Its function is to manage the sensations of defecation / urination as well as those of sexual arousal. It does not carry parasympathetic fibers, as it only deals with engaging the organs and muscles in the perineum. 

Its two most important branches are:
- the Perineal Nerve (innervating the perineum area)
- the Dorsal Nerve (innervating the penis and clitoris)

Orgasms and perineal feelings during orgasms (spasms with ejaculation or orgasms) are possible due to both the pudendal and pelvic nerves


So, as you can imagine, any damage happening along any of these detailed pathways can cause issues with sexuality in an individual living with Multiple Sclerosis.

This is one very important aspect for all ages, but it's almost crucial for young people, as it's part of the way they perceive themselves, but most importantly, it is the function that will insure a full relationship with a partner and the ability of creating a family.


It's important to understand how MS is affecting both of you. Blame or accusation and criticizing need to be avoided, as they will always have a negative impact, on the situation and both of you. Talk about your wants, fears and frustrations. Ask questions and be ready to answer theirs.

For some of you, saying things out loud might not be comfortable, so the best alternative is to write what you're experiencing and what are the feelings associated with those issues. You can then either ask your partner to read what you wrote, or have a better ability to talk about the situation yourself.

Explore, remember, try new things. Sexuality is not a fixed thing, it doesn't have to happen by a fixed scenario. Be open minded and work with your partner to find the best way to making your sexual relationship more pleasurable. We are all different and it's a private issue, so you know best what fits you. Make choices accordingly.

Look after yourself and take care of your body. A good diet, regular exercise, enjoying relaxing activities and spending some time on your personal appearance can make wonders. Both to your self-confidence and to how your partner sees you.

Last but not least, learn about how MS works inside your body (and mind). Find out more about how it can affect relationships and sexual function. It will make it easier to understand what you're going through while getting better at explaining it to your partner.

Given this context, this is the first part of many, discussing this topic. So, I invite  you to comment down below, ask questions, write your opinions, and let's make this series an opportunity for mutual learning and discovery. Have you had any issues with this? Do you have anything to add?

The more we learn, the better the outcome. One cannot fight that what is invisible. Let's inform each other! It's the best way to be able to make the smart choices that best suit our lifestyles.

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2 comentarii:

  1. It is very important before trying any method you should seek medical advice first.

    1. Hi Jim! Thank you for the useful add. I agree, doctors need to know if something goes wrong with the sexual function. It's a back-and-forth information exchange between the MSer and the neurologist. Sexuality is a private matter, but I agree that all choices need to be verified for safety first.